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Overdose: There have been cases of overdose with thiamine or cyanocobalamin

doi: 10.3390/healthcare12030386

Although some commenters referred to billing activity that ACOs may suspect to be SAHS billing activity, we wish to reiterate that CMS will have the sole discretion to identify cases of SAHS billing activity for a particular calendar year that warrant adjustment of Shared Savings Program financial calculations, for CY 2024 or subsequent calendar years, in the approach we are finalizing in section III.G.7.d of this final rule

Sleep improvements are usually felt within the first few weeks

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